The DAPA-CKD trial evaluated the efficacy and safety of dapagliflozin in patients with chronic kidney disease, regardless of whether they had type 2 diabetes. The study randomly assigned 4304 participants with an estimated glomerular filtration rate (GFR) of 25 to 75 ml per minute per 1.73 m² and a urinary albumin-to-creatinine ratio of 200 to 5000 to receive either dapagliflozin (10 mg once daily) or placebo. The primary outcome was a composite of a sustained decline in the estimated GFR of at least 50%, end-stage kidney disease, or death from renal or cardiovascular causes. Over a median follow-up of 2.4 years, the primary outcome event occurred in 197 participants (9.2%) in the dapagliflozin group and 312 participants (14.5%) in the placebo group (hazard ratio, 0.61; 95% CI, 0.51 to 0.72; P<0.001). The hazard ratio for the composite of a sustained decline in the estimated GFR of at least 50%, end-stage kidney disease, or death from renal causes was 0.56 (95% CI, 0.45 to 0.68; P<0.001), and the hazard ratio for the composite of death from cardiovascular causes or hospitalization for heart failure was 0.71 (95% CI, 0.55 to 0.92; P=0.009). The safety profile of dapagliflozin was confirmed, with no cases of diabetic ketoacidosis reported. The trial concluded early due to clear efficacy, and the results suggest that dapagliflozin can significantly reduce the risk of adverse outcomes in patients with chronic kidney disease, regardless of their diabetes status.The DAPA-CKD trial evaluated the efficacy and safety of dapagliflozin in patients with chronic kidney disease, regardless of whether they had type 2 diabetes. The study randomly assigned 4304 participants with an estimated glomerular filtration rate (GFR) of 25 to 75 ml per minute per 1.73 m² and a urinary albumin-to-creatinine ratio of 200 to 5000 to receive either dapagliflozin (10 mg once daily) or placebo. The primary outcome was a composite of a sustained decline in the estimated GFR of at least 50%, end-stage kidney disease, or death from renal or cardiovascular causes. Over a median follow-up of 2.4 years, the primary outcome event occurred in 197 participants (9.2%) in the dapagliflozin group and 312 participants (14.5%) in the placebo group (hazard ratio, 0.61; 95% CI, 0.51 to 0.72; P<0.001). The hazard ratio for the composite of a sustained decline in the estimated GFR of at least 50%, end-stage kidney disease, or death from renal causes was 0.56 (95% CI, 0.45 to 0.68; P<0.001), and the hazard ratio for the composite of death from cardiovascular causes or hospitalization for heart failure was 0.71 (95% CI, 0.55 to 0.92; P=0.009). The safety profile of dapagliflozin was confirmed, with no cases of diabetic ketoacidosis reported. The trial concluded early due to clear efficacy, and the results suggest that dapagliflozin can significantly reduce the risk of adverse outcomes in patients with chronic kidney disease, regardless of their diabetes status.